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Upper Endoscopy With Bile Duct Stone Breakup

South Carolina rates for HCPCS 43265

A flexible scope is passed through the mouth to the opening of the bile and pancreatic ducts, and a stone that is too large or too wedged to pull out whole is broken into pieces first. The fragments are then removed or allowed to pass. Dye and X-ray pictures are used to find the stone and confirm the duct is clear.

Rates data updated July 2026.

How much does Upper Endoscopy With Bile Duct Stone Breakup cost?

$1,175

Typical facility fee. In South Carolina, July 2026.

Insurers have agreed to pay about $1,175 for this service. Most negotiated rates run $646 to $7,079.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1,202 · 10th to 90th $513 to $12,589Professionalmedian $794 · 10th to 90th $741 to $933
$500$1K$2K$5K$10K$20Kfacility $1,202professional $794

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$7,244.36
Typical High
$22,908.68
BCBS
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$3,019.95
Typical High
$8,912.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$575.44
Typical High
$3,467.37
Medcost
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$794.33
Typical High
$933.25
Medcost
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$676.08
Typical High
$1,023.29
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$10,232.93
Typical High
$17,378.01

Where South Carolina sits

The same service costs 72.4 times more in West Virginia than in North Dakota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Carolina· 38th of 50

$1,175

WV $31,623ND $437

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.